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Health Markets Insurance can help navigate ACA

Subsidies are available for those who qualify

Published in the Feb. 5, 2014 issue of Morgan Hill Life

By Staff Report

Ron Almaraz

Ron Almaraz

Ron Almaraz is a licensed Health Markets Insurance agent in Morgan Hill who wants to help local residents understand the details of the Affordable Care Act to get the most out of their healthcare opportunities. Morgan Hill Life recently asked him to explain this newly implemented legislation.

Nationally, health care is undergoing a tectonic shift with the implementation of the ACA, also known as ObamaCare. What does this mean for residents of Morgan Hill?

It means individuals who could not qualify for health insurance because of their medical history will now be able to get health insurance. Under the ACA, health insurance is now guaranteed. Those individuals who previously could not afford health insurance may now have access to a subsidy to help pay for their health insurance if their household income/family size falls below 400 percent of the Federal Poverty Level. Finally, those individuals who can afford health insurance but do not have coverage in 2014 may have to pay a penalty.

What are the timelines for rolling out the new care system?

The Affordable Care Act is a set of health insurance reforms that started in 2010 and will continue to roll out in 2014 and beyond. Open enrollment in the health insurance marketplace started Oct. 1, 2013 and will end March 31, 2014. Coverage began Jan. 1, 2014. However if you enroll by March 31, 2014 you will not have to pay the penalty for any month before your coverage began. If you didn’t have coverage earlier in the year, you won’t have to pay a penalty for any of the previous months of 2014. After open enrollment ends, you won’t be able to get health coverage through the marketplace until the next annual enrollment period. The proposed open enrollment period for 2014 coverage is Nov. 15, 2014 to Jan. 15, 2015. There will be a special enrollment period if an individual has a qualifying life event.

Health insurance is a very confusing issue for people to understand. What’s the best way for people to educate themselves so they can best benefit from it?

To become more educated on the Affordable Care Act, go to www.healthcare.gov or the Covered California (CoveredCA) website (https://www.coveredca.com/) to learn the basics of healthcare reform. You can also contact a local licensed CoveredCA certified agent who will assist you with the application process, determining whether you’re eligible for cost assistance, and can help in designing a plan to suit your needs.

Will ObamaCare force people to switch doctors, have their company cut their hours, violate their privacy or end employer-run health insurance?

All ACA health plans are managed care plans and consequently all have networks that the insured’s must utilize to either be covered (HMO or EPO) or maximize their coverage (PPO). HIPAA Laws will continue to mandate privacy in the healthcare arena.
Some small business owners may elect to discontinue providing their employees access to health insurance and may subsidize their premiums instead or direct their employees to the marketplace to get their premium subsidized from the exchange if their family size and household income qualifies them for a subsidy/premium tax credit.

Ronnie Almaraz is the owner of Health Markets Insurancde in Morgan Hill. Call him at (408) 687-0731 or visit his website at www.insphereis.com/ronnie.almaraz